Heterotopic Ossification with and without Neovascularization in Aortic Valves: A Histopathological StudySusumu Matsukuma1,2*, Ayano Koga1, Hiroaki Takeo1 and Kimiya Sato1
- *Corresponding Author:
- Susumu Matsukuma
Health Care Center
Japan Self-Defense Forces Central Hospital
1-2-24 Ikejiri, Setagaya-ku, Tokyo 154-0001, Japan
Tel: +81-3-3411-0151 Ext. 6446
E-mail: [email protected]
Received Date: August 21, 2014; Accepted Date: September 16, 2014; Published Date: September 16, 2014
Citation: Matsukuma S, Koga A, Takeo H, Sato K (2014) Heterotopic Ossification with and without Neovascularization in Aortic Valves: A Histopathological Study. J Cytol Histol 5:279. doi:10.4172/2157-7099.1000279
Copyright: © 2014 Matsukuma S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Heterotopic ossification can be found in neovascularized aortic valves with end-stage valvular disease, but its histopathological characteristics are not fully understood. The present study found ossification and neovessels in 21 (28%) and 54 (72%) of 75 surgically removed dysfunctional aortic valves, respectively; there was a significant association between them (P<0.001). Fatty bone marrow was found in 5 aortic valves (6.7%) and always contained neovessels. Neovessels could be divided into thick-walled, arteriole-like vessels (ThKA-Vs) and thin-walled, capillarylike vessels (ThNC-Vs). ThKA-Vs would be a hallmark of rheumatic disease, were always accompanied by ThNCVs, and were closely related to ossification (P=0.046). ThNC-Vs may be in part branches of ThKA-Vs, but were also identified in 23 aortic valves without ThKA-Vs. In 44 non-rheumatic dysfunctional aortic valves, such ThNC-Vs only were also associated with ossification (P=0.004). In addition, the present study revealed vessel-independent focal/ minute ossification without nearby neovessels in 6 dysfunctional aortic valves, and also in 4 of 75 age- and sexmatched postmortem non-dysfunctional aortic valves with no neovessels or prominent calcification/thickening; there were no significant differences in the incidence between them. Neovascularized vessels would consist of rheumatic neovessels (ThKA-Vs and their branches) and non-rheumatic neovessels (ThNC-Vs only), and the presence of neovessels is one of the risk factors for aortic valvular ossification. However, aortic valvular ossification can occur in various pathogeneses, such as rheumatic neovessel-dependent ossification, non-rheumatic neovessel-dependent ossification, and rarely vessel-independent focal/minute ossification.